Happy birthday (November 29) to the Father of Neurology, Jean-Martin Charcot (1825-1893)!
I wouldn't say we're best friends exactly, but yeah, we used to hang out in Paris together. 1/4
Charcot was a neurologist in Paris in the late 1800s, when neurology was developing as a field. He was the 1st chair of neurology, and was a celebrity doctor at the time (this is a poem written and published in the newspaper after his death in 1893). 2/8
He was so famous that charlatans used his name after his death to sell "Kola Nervine Tablets" made from the "wonder-working Kola nut." 3/8
While much of nascent neurology was focused on neuropath and anatomic localization, Charcot was a clinician, describing diseases and working toward treatments (primarily hypnosis). 4/8
A lot has been written on this guy.
Chris Goetz from Rush has done amazing research on Charcot, including books Charcot: Constructing Neurology, and Charcot, the Clinician (translated lectures). 5/8
If you're looking for a short paper to tell you a little about the man, the myth, the legend, check out this one by Goetz on "Charcot and the Myth of Misogyny" n.neurology.org/content/52/8/1… 6/8
Isabelle Rapin is the perfect Luminary to discuss today, because she was born December 4🎂and was a founding member of the @ChildNeuroSoc in 1973 in #Nashville (where everyone is going for #AES2022).
Peds neurologists know why she has a pinwheel on her card - do you? 2/🪑
Born in Lausanne, Switzerland - where Augusta Déjerine-Klumpke studied - Rapin went to medical school locally. Like ADK, she worked at the Salpétrière - and like ADK, she wrote a brief autobiography (please write one, send to @JChildNeurol) journals.sagepub.com/doi/10.1177/08… 3/🪑
****************************************
Luminary #4: Dorothy Russell (1895-1983)
1/🪑
Hands up if you used this textbook! The 7th edition of "R&R" was published in 2007.
You may have known that this was written by eminent neuropathologist Dorothy Russell, but did you know she had epilepsy? 2/🪑
Russell was born in Australia, but after both her parents died (her mother from measles), Dorothy and her sister Petronella went to live in England with an aunt. 3/🪑
****************************************
Luminary #1: Sarah McNutt (1839-1930)
1/🪑
In 2002, Horn and Goetz published this excellent paper on McNutt - the 1st woman elected to the American Neurological Association (@TheNewANA1) - and her work with other early female physicians, including the Blackwells. n.neurology.org/content/59/1/1… 2/🪑
McNutt came from a long line of female midwives and healers, including Sarah Weir, who worked on Nantucket, and Rachel Hussey, who delivered 2992 children (both called physicians here, but neither MDs) 3/🪑
Edwin Smith, born in Connecticut, lived in Egypt in the late 1800s. An antiquities dealer, he bought a papyrus in 1862 that he was unable to translate.
Smith died in 1906, and his daughter donated the scroll to the New York Historical Society.
In 1920, Egyptologist Caroline Ransom Williams found it and recognized its worth. She wrote to her mentor James Henry Breasted and asked him to translate it. brewminate.com/the-contributi…
Ransom Williams felt she was too occupied with family to take it on.
“The papyrus is probably the most valuable one owned by the Society and I am ready to waive my interest in it, in the hope that it may be published sooner and better than I could do it.” [November 22, 1920]
Bradford-Hill's trial of streptomycin for TB (see my thread from earlier today) was the first randomized controlled trial - but not blinded, and not placebo controlled. There was another trial, around the same time, for a medication called patulin. 1/6
You've never heard of patulin? It's a mycotoxin (it grows on apples), once used as an antibiotic (but not any more, due to toxicity).
In the 1940s, it was billed as the cure for the common cold. 2/6
A study showed that if you spray patulin in someone's nose when they have a cold, they feel much better - within 48 hours - than people who didn't receive any treatment.
This was huge! Everyone wanted patulin to treat colds.
So what happened? 3/6
Here’s a good story about the placebo effect – on physicians:
If you had a stroke in 1810, it would have been diagnosed clinically, without MRI. Your doctors knew that if you died, your brain held either fluid (edema, ischemic stroke) or blood (hemorrhagic stroke). 1/
So obviously the problem was that there was too much fluid in your body.
Solution? Reduce fluid, by blood-letting. This was the solution to a lot of things (one of these days I'll do a #histmed#tweetorial on Benjamin Rush).
And many people got better. 2/
People got better because when you have a small stroke, inflammation and edema make symptoms worse initially, and then, over time, symptoms improve.
If they didn't get better? Easy - you didn't bleed them enough. 3/